QTc prolongation and premature ventricular contractions (PVCs) are common in hemodialysis (HD) patients and are associated with sudden cardiac death.
It is known that higher dialysate bicarbonate is associated with more QTc prolongation during HD sessions.
This study aims to assess the effects of lower (30 mEq/L) versus higher (35 mEq/L) dialysate bicarbonate in adult maintenance HD patients admitted to the hospital.
The investigators will randomly assign subjects to lower versus higher dialysate bicarbonate concentrations during their hospital stay for up to a maximum of six HD sessions or until their hospital discharge.
prevalent end-stage renal disease, on maintenance HD > 90 days
age ≥ 18 years old
thrice weekly HD
hemoglobin < 8.0 g/dL
pregnancy
any physical, mental or medical condition which limited the ability to provide written informed consent